Only 11 percent of commercial health care payments to doctors and hospitals is tied to performance or designed to cut waste, according to a new National Scorecard on Payment Reform by Catalyst for Payment Reform (CPR). By comparison, 89 percent of payments are made through payment methods that do not have a quality or other performance components and the traditional fee-for-service system.
Among payments tied to value, just 60 percent involve providers taking on a share of the risk, meaning they stand to lose money if they do not meet certain quality and efficiency measures or exceed a budget. The rest are in programs such as pay-for-performance, which offer incentives for providing high-quality care, but do little to discourage overuse or inappropriate care.
CPR, an employer-founded nonprofit focused on creating greater value in healthcare, has a goal of having at least 20 percent of health care payments will be value-oriented by the year 2020.